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Submission
Requirements

Submission Requirements

Requirements for Educational Grants

To expedite grant request processing:

  • Submit your educational grant request on-line at least 60 days prior to the date of the proposed educational program/initiative. It is the requestor’s responsibility to submit application materials in a timely fashion and in consideration of the proposed date of the educational program/initiative.
  • Submit only completed forms and submit all forms at once. If all forms are not submitted and/or any are incomplete, the grant request will not be reviewed
  • Forms to be submitted include:
    • Grant Request Form, completion of which includes requestor and program information such as a description of the activity, its educational purpose, and tax identification number
    • Program Agenda, if applicable, with timing, title(s), target audience, speakers (if selected), whether CME/CE credits will be awarded, and learning objectives
    • The amount of funding requested, including a budget detailing the proposed use of funds
    • W-9

Requirements for Charitable Grants

To expedite grant request processing:

  • Submit your educational grant request on-line at least 60 days prior to the date of the proposed educational program/initiative
  • Submit only completed forms and submit all forms at once. If all forms are not submitted and/or any are incomplete, the grant request will not be reviewed
  • Forms to be submitted include:
    • Grant Request Form, completion of which includes requestor and program information such as a description of the activity, its purpose and tax identification number
    • Mission Statement
    • Program Agenda, if applicable, with timing, title(s), target audience, speakers (if selected), and learning objectives.
    • The amount of funding requested, including a budget detailing the proposed use of funds
    • W-9
    • IRS Letter of Determination providing evidence of 501 (c)(3) tax-exempt status

Please return all Grant Request Forms and supporting documents to:

  • Salix Pharmaceuticals, Inc.
  • Grants Coordinator, Medical Affairs
  • Fax: 888-314-5934
  • E-mail:

Confirmation and Notification

  • An e-mail will be sent to confirm receipt of the grant request
  • Salix's grant committee review process will take approximately 4-6 weeks
  • Once the review process is complete, a notification with the decision will be sent
  • If approved, a Salix-signed Letter of Agreement will be sent
  • Authorized person/organization will receive the grant payment within 4 weeks of approval

Budget Guidelines

  • Grant requests must include a reasonable and comprehensive budget outlining the cost of grant-funded activities
  • Grants may be issued to support only the costs associated with the development, delivery or evaluation of the educational program, resources, or materials
  • Grants may not cover costs that are neither reasonable nor customary

COLAZAL® (balsalazide disodium) Capsules 750 mg are indicated for the treatment of mildly to moderately active Ulcerative Colitis in patients 5 years of age and older. COLAZAL does not relieve symptoms in all patients; your patients' results may vary. In four well-controlled clinical trials, patients receiving a COLAZAL dose of 6.75g/day most frequently reported the following events (reporting frequency > 3%): headache (8%), abdominal pain (6%), diarrhea (5%), nausea (5%), vomiting (4%), respiratory infection (4%), and arthralgia (4%). Withdrawal from therapy due to adverse events was comparable to placebo. In the pediatric trial, patients most frequently reported the following adverse events: headache (15%), abdominal pain upper (13%), abdominal pain (12%), vomiting (10%), diarrhea (9%), colitis ulcerative (6%), nasopharyngitis (6%) and, pyrexia (6%). COLAZAL is contraindicated in patients with a hypersensitivity to salicylates or the components of COLAZAL capsules or balsalazide metabolites. The safety and effectiveness of COLAZAL beyond 8 weeks in children (ages 5-17 years) and 12 weeks in adults have not been established.

Consult with your physician to see if this product is right for you.

For complete Prescribing Information, please click here.

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Colazal Co-Pay Value Card